The prevalence of clinical anxiety and clinical depression in rheumatic
diseases is about twice the prevalence seen in the general population.
At a milder level, the occurrence of psychological distress that does not
fulfill diagnostic criteria of anxiety and depression is even higher. Evidence
indicates that this high prevalence is multifactorial. Correlational studies suggest
that possible factors for anxiety and depression include the suffering accompanying
somatic symptoms, functional limitations, pro-inflammatory cytokines, helplessness
due to the uncontrollable, unpredictable, and progressive nature of the disease, and
other factors associated with having a chronic disease. This article reviews the
prevalence and diagnosis of anxiety and depression in rheumatic diseases and it
examines the contents and the impact of psychological interventions to address these
difficulties for patients.